Health Care Progress Report: November 23

(CBS)  The entire Senate will finally have a chance to deliberate health care reform legislation, after the Democrats on Saturday managed to eke out 60 votes to move their bill forward. Saturday's vote to start debate was an important one for Senate Majority Leader Harry Reid, who aims to pass a bill before the year's end. He faces a number of challenges, however, that could keep the Senate from catching up with the House.

CBSNews.com Special Report: Health Care

As Washington lawmakers work through the six major steps they need to complete to pass a health care reform bill, CBSNews.com is tracking their progress for you on the chart below. The House of Representatives passed a health care bill earlier this month, and it must wait for the Senate to do the same before either chamber can move on to the fourth step.

(CBS)

More on the progress of health care legislation in each chamber of Congress:

(AP Photo/Harry Hamburg)

SENATE: After a dramatic day on the Senate floor Saturday, Harry Reid managed to get all 60 Senate Democrats to vote in favor of debating his health care bill. Two conservative Democrats, Mary Landrieu (La.) and Blanche Lincoln (Ark.) waited until Saturday to announce they would stick with their party. Sen. Ben Nelson (Neb.), another conservative Democrat with reservations about the reform plan, revealed on Friday he would support the procedural vote.

It is a good sign for Democrats that Reid was able to get the bill this far; most bills that pass the initial procedural vote to begin debate are eventually approved. Before there are any more votes on the bill, though, Reid has to guide negotiations over a number of contentious proposals, like the government-run health insurance plan or "public option," abortion coverage, and revenue-raising provisions.

As it currently stands, the bill Reid unveiled Wednesday night would extend coverage to 94 percent of eligible Americans at a cost of $849 billion, according to the nonpartisan Congressional Budget Office. CBS News correspondent Nancy Cordes and CBS News producer John Nolen explained the bill, point by point, on CBSNews.com's Political Hotsheet blog.

On reports that Bernie Sanders, a Vermont independent who votes with Democrats, said he would not vote for a bill without a public option.

Politics will no doubt come into play as Democrats in the Senate decide what to do about issues like the public option. Blanche Lincoln is particularly vulnerable to political considerations because she is up for re-election in 2010 in an increasingly Republican state. As soon as Lincoln revealed on Saturday she would vote in favor of moving the debate forward, the Republican party immediately issued a press release, the New York Times reports, making her sound responsible for the bill.

5571234HOUSE: House Democrats have to remain united as well, even though they passed their bill earlier this month. Once the Senate accomplishes the third step and approves its own bill, Democrats in the House and the Senate will have to combine their two plans in a conference committee. It could be difficult to fashion a single bill acceptable to Democrats in both chambers.

The House managed to pass a bill with a public option, but it remains to be seen if they will accept whatever version of the public option the Senate approves, if any. Meanwhile, some Democrats in the House the bill that comes out of conference if it still contains the abortion language added to the House bill. Abortion rights groups stepped up their lobbying campaign against the measure last week.

Female House members also took center stage to debate new breast cancer screening recommendations put forward by an independent panel. GOP congresswomen said last week the recommendations foreshadow the rationing they say the Democrats' health care plan will mandate. Democrats insisted the recommendations would not drive policy.

Meanwhile, the House last week passed in a separate bill a "Medicare fix" that prevents doctors from seeing a 20 percent pay cut from the federal program. The measure is not paid for and must still be approved in the Senate. Democrats have kept the measure separate from their comprehensive health care reform plan because they want the reform package to be deficit-neutral.

[AscentVIP]

It was as if they had a <a href="http://www.ascentvip.com">concierge</a> service that helped it through.

[lakota2012]

by newyorkmom:
Wouldnt you think that the doctors in this country would be allowed to have some input in a decision such as this?
============================================






They have already been moving towards concierge care for more money and less patients in the last few years, so that the wealthiest can have cadillac care over the rest of us in managed care!


Concierge medicine (also known as "Direct Care") is a term used to describe a relationship with a primary care physician in which the patient pays an annual fee or retainer. This may or may not be in addition to other charges. In exchange for the retainer, doctors provide enhanced care. Other terms in use include boutique medicine, retainer-based medicine, and innovative medical practice design.

http://en.wikipedia.org/wiki/Concierge_medicine

[lakota2012]

Concierge Medicine | Concierge Medical Practice | Primary Care ...
If you are also looking for a primary care medical practice as well as primary care physician, concierge choice physicians and concierge healthcare, ...
choice.md/

[PDF] GAO-05-929 Physician Services: Concierge Care Characteristics
Concierge care is practiced by a small number of physicians located mainly ... physician services suggests that concierge care does not present a systemic ...
www.gao.gov/new.items/d05929.pdf

[lakota2012]

Patients face bitter choice: Pay up or lose care

Premium-pay medical practices grow as doctors seek more control, cash


5,000 concierge doctors ? and growing

As many as 5,000 doctors nationwide have opted for full or partial concierge practices. Surveys suggest that number could quadruple within the next few years.

The result, critics say, is a segregated system that offers extra access for extra cash, even as it escalates a looming health care crisis for everyone else. And there?s nothing in the current health reform bills being considered in Congress to stop it.

?These practices exacerbate a fundamental problem in our health care system, which is this health care chasm between the haves and the have-nots,? said, Laura Weil, director of the health advocacy program at Sarah Lawrence College in Bronxville, N.Y., and an analyst of concierge care.

Here?s how concierge medicine works: Doctors charge anywhere from $1,500 per person per year up to $25,000 or more for a family. This fee acts as a retainer on top of all the insurance-covered services.

In some programs, those who don?t pay are forced to leave the practice. In others, they?re likely to see a nurse practitioner, a physician assistant or a newer, different doctor hired to handle the traditional patients.

The U.S. is short by between 40,000 and 50,000 primary care doctors now, a figure that?s expected to top 125,000 by 2020, according to the American Academy of Family Physicians. That means people who don?t want or can?t afford concierge plans will have a harder time than ever finding a doctor.

[Brokennews]

"I didn't anticipate being in this position. I thought it would pass. Maybe Harry has some magic up his sleeve. But I don't see how he gets those four votes [Sens. Joseph Lieberman (Conn.), Mary Landrieu (La.), Blanche Lincoln (Ark.) and Ben Nelson (Neb.)] without compromising the bill."

Howard Dean on-air interview with MSNBC's Dylan Ratigan



Shouldn't Dean be one of the cheerleader here &#38; not a buzzkill. Now, even the highest ranking Dems are starting to act like it's over. Maybe it is.
BTW--That was some classic money grubbing by Mary Landrieu. $300 million, what a score. Usually bribes are asked for behind closed door, but to see it being asked for out in the open on the floor was truly impressive. Ethics aside, this chick has some serious kahonies!!

[mikeoliphant]

Senate Majority Leader Harry Reid (D-NV) released a merged version of the Senate comprehensive reform on 11/19/09, which Mike Oliphant whom manages Utah health insurance plans for http://www.benefitsmanager.net/selecthealth.html employers could get behind and support some of it (Patient Protection and Affordable Care Act, or H.R. 3590). This should encourage the private sector health insurance carriers to form INSURANCE EXCHANGES which is what we have done here in Utah. They carry the risk and burden, not the tax payer. See more about this at www.utahhealthplans.info

[lakota2012]

by rrisright:
We already have a 24 trillion Obama deficit by 2014
=============================================




by hungry1968-17:
Where in the world do you get your numbers from?!?!?
=============================================








Economically-challenged "born again" fiscal conservatives obviously pull numbers like that out of their arses, or just parrot the latest rush/beck/hannity propaganda!

[brendett]

I don't know about you, but I'm getting a sick and tired of hearing the Republicans acting so self-righteous about this health care bill. we don?t know if it will work yet because its never been done before but let's take a short trip down memory lane.

In November 2003, almost all Republican senators voted to pass the "Prescription Drug and Medicare Improvement Act of 2003."
That was a Provoking humongous Medicare expansion that ended up costing about $1.2 trillion.
It was a huge federal government intrusion into our health care system.
"Now the Republican Party has a problem with the Democratic Party over this health care bill" Why?
Republican senators spend 1.2 trillion on Medicare wasn't that a government involvement of our health care system also ?
Did our taxes go up for that bill ? Ask a Republican Senator the question!

[lakota2012]

by brendett:
I don't know about you, but I'm getting a sick and tired of hearing the Republicans acting so self-righteous about this health care bill. we don?t know if it will work yet because its never been done before but let's take a short trip down memory lane.
============================================




Exactly! These self-righteous "born again" fiscal conservatives are the most hypocritical, economically-challenged morons in America!

The GOP senators will continue to vote for the unsustainable and unaffordable for-profit health care status quo.

[rrisright]

Does anyone really believe that beyond 10 years with this plan we can afford a 2.5 trillion a year plan. We already have a 24 trillion Obama deficit by 2014, a 50 trillion unfunded social security liability. Why do you want to destroy the currency for our children and grand children. 85% are happy their private insurance, we do not need a govt plan. There is not one model in the world that works efficiently, Mass and Tenn are both broke. It takes an averate of 60 days to see an internist in Mass, in states wit non public plans it takes 6.

[hungry1968-17]

Where in the world do you get your numbers from?!?!?

Is there no depth to how low the lies from the conservatives will stoop?!?!

[lakota2012]

by rrisright:
We already have a 24 trillion Obama deficit by 2014, a 50 trillion unfunded social security liability.
========================================




Do you have any idea of how ignorant and economically-challenged you sound?

According to the ex-Comptroller General, David Walker, we do indeed have $40 Trillion in unfunded future liabilites, but this is mainly from the Medicare/Medicaid soaring costs and 80 Million retiring baby boomers over the next 2 decades.

The current yearly budget deficits we've seen since 2000, are mainly due to the bush tax cuts that reduced federal revenue, and the vast expenditures of 2 long wars and no-bid contracts, the Medicare Part D gift to BIG PHARMA and TARP bailouts/stimulus spending. President Obama was handed a $1.2 Trillion budget deficit by the bushies on Jan. 20th, 2009, and the fiscal year just ended on Oct. 1st, with a budget deficit of $1.4 Trillion.

You "born again" fiscal conservatives just continuously parrot the same garbage daily, and just show your ignorance between yearly budget deficits and the national debt that republicans increased over the past 30 years. The national debt stood at $11 Trillion at the beginning of 2009, and mainly due to stabilizing the worst economic catastrophe since the Great Depression, our national debt is now $12 Trillion for an 8% increase compared to the 100% increase during bushworld!

[ahrats]

If Congress passes this Health Care TAX now the average person will have to choose between paying for their food or paying the insurance co. WE THE PEOPLE just bailed out finanical institutions and insuracnce companies and car companies which will already RAISE OUR TAXES TO PAY. As a life long DEMOCRAT I'm very disappointed in my party, They are shouving a TAX down our throats in the name of Health Insurace which will make Insurance Co. lots of more money, give heatlth care to the poor, rich will find a loop hole so they do not pay this TAX, so me the average guy gets to pay for congresses mistake (TAX). The only part of the economy that is making out right now is the finanical companies, who just got bailed out and now have so much money their giving large bonuses to their executives again and are giving the american people the finger. Congress does not have to pay this new Health Insurace TAX, WE THE PEOPLE pay it for them.

[tmittelstaed]

The only problem with the 2 different morals to the same story post is that in reality, the ant is gathering grain that was paid for by farm subsidies that the wealthy Republicons passed, hauling this subsidized grain on a road maintained out of the state general fund because the Republicans refuse to institute a tax like the weight-mile tax that actually fairly proportions the burden of maintaining the roads, and is heating his home with electrical power subsidized by the Republicans who are putting the burden of spent nuclear fuel rod disposal that generates that power on the taxpayers funding Yucca Mountain.

Of course, the ant can pretend he's "working" even though the taxpayers are underwriting his "work"

[bcpats]

Two Different Morals to the same story:


OLD VERSION:

The ant works hard in the withering heat all summer long, building his house and laying up supplies for the winter.

The grasshopper thinks the ant is a fool and laughs and dances and plays the summer away.

Come winter, the ant is warm and well fed. The grasshopper has no food or shelter, so he dies out in the cold.

MORAL OF THE STORY: Be responsible for yourself !

MODERN VERSION;

The ant works hard in the withering heat and the rain all summer long, building his house and laying up supplies for the winter.

The grasshopper thinks the ant is a fool and laughs and dances and plays the summer away.

Come winter, the shivering grasshopper calls a press conference and demands to know why the ant should be allowed to be warm and well fed while he is cold and starving.

CBS, NBC , PBS, CNN, and ABC show up to provide pictures of the shivering grasshopper next to a video of the ant in his comfortable
home with a table filled with food.

America is stunned by the sharp contrast.

How can this be, that in a country of such wealth, this poor grasshopper is allowed to suffer so ?

Kermit the Frog appears on Oprah with the grasshopper and everybody cries when they sing, 'It's Not Easy Being Green.'

Acorn stages a demonstration in front of the ant's house where the news stations film the group singing, 'We shall overcome.'

Rev. Jeremiah Wright then has the group kneel down to pray to God for the grasshopper's sake.

President Obama, Harry Reid and nancy Pelosi condemn the ant and blames President Bush, President Reagan, Christopher Columbus, and the Pope for the grasshopper's plight.

Nancy Pelosi &#38; Harry Reid exclaim in an interview with Larry King that the ant has gotten rich off the back of the grasshopper, and both call for an immediate tax hike on the ant to make him pay his fair share.

Finally, the EEOC drafts the Economic Equity &#38; Anti-Grasshopper Act retroactive to the beginning of the summer.

The ant is fined for failing to hire a proportionate number of green bugs and, having nothing left to pay his retroactive taxes, his home is confiscated by the Government Green Czar and given to the grasshopper.

The story ends as we see the grasshopper and his free-loading friends finishing up the last bits of the ant's food while the government house he is in, which, as you recall, just happens to be the ant's old house, crumbles around them because the grasshopper doesn't maintain it.

The ant has disappeared in the snow, never to be seen again.

The grasshopper is found dead in a drug related incident, and the house, now abandoned, is taken over by a gang of spiders who terrorize the ramshackle, once prosperous and once peaceful neighborhood.

The entire Nation collapses, bringing the rest of the free world with it.

MORAL OF THE STORY: Be careful how you vote in 2010

[mikejacobskc]

The whole premise of the health care debate is incredibly dishonest. Let's just come out and say that this is going to be a very expensive expansion of access to health care, that is a fact. Whether you agree or disagree on the "public option", can't we all agree that this is NOT going to be deficit neutral? To say that this won't add to the deficit, with a straight face, hiding behind a bunch of phoney projections that anyone on to this blog could find 10 sources to prove or disprove, is just intellectually dishonest. If the Democrats believe so strongly in the "public option", just come right out and say, "it's going to expand access to health care for millions, and it's going to cost billions of dollars." That's the truth of the matter, but the Democrats are too cowardly to say it.